Effects of Cushing’s syndrome on the human brain

Cushing's syndrome (CS) is characterized by excessive exposure to cortisol, and is associated with both metabolic and behavioural abnormalities even after biochemical cure. Andela et al conducted a systematic review of literature available in the PubMed, Embase, Web of Knowledge, and Cochrane databases evaluating structural and functional changes in the brain identified by magnetic resonance imaging in CS patients. They also reviewed potential associations between brain characteristics and disease status, cognitive functioning, psychopathology, and general well-being.

They found CS has profound effects on the human brain including abnormalities in structural grey matter, possibly white matter and neurochemical and functional alterations. After correction of hypercortisolism, the structural and neurochemical alterations improve substantially and correlate with improvements in clinical and behavioural outcomes. Nevertheless, abnormalities in both grey- and white matter are not completely reversible at long-term remission and are accompanied by psychological symptoms and impairments in cognitive functioning.

The full review by Andela et al. is published in the European Journal of Endocrinology 2015 173, DOI:10.1530/EJE-14-1101